Buttock pain

Symptoms of buttock pain may include:

Pain

Buttock pain varies according to the cause. It can be mild or severe and may vary from a sharp shooting pain to a dull ache. You may have pain all the time, or it may come and go. Pain may be in your anus and rectum (back passage), joints, nerves, or muscles. It may radiate down the backs of your legs. Your pain may be worse when doing certain activities, like walking or sitting. In some cases, pain can result in restricted mobility and make it difficult to perform certain activities.

Bruising or swelling

Bruising or discolouration of the skin may be present if you have injured your buttocks during an accident or fall. Bruising occurs when blood vessels are damaged, causing bleeding under the skin. It may be accompanied by swelling. Bruises change in colour from red or pink to blue and purple and finally pale green and yellow as they heal. Most bruises heal fully within 2 to 3 weeks.

Numbness, tingling and weakness

If you experience numbness, tingling, weakness, or pain that radiates down your leg, it could be a sign of a herniated disc. See your doctor as soon as possible if you experience these symptoms.

There are multiple causes of buttock pain, ranging in severity from mild and treatable at home, to serious and requiring medical treatment.

Some common causes of buttock pain include:

Trauma

Trauma to the buttocks may result from a blow to the area or a fall. They are common during sporting activities such as rollerblading, ice skating or skateboarding. The area may appear bruised and swollen and will probably be tender when you touch it. Treatment is normally with rest, painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), and the application of ice and heat packs. Trauma to the anus or rectum can also cause buttock pain and spinal injuries may radiate to the buttocks.

Muscle strain

The buttocks are made up of 3 muscles, the gluteus maximus, gluteus medius and gluteus minimus. A muscle strain occurs when one of these muscles stretches and tears. Symptoms of muscle strain include pain, swelling, tenderness and difficulty moving the affected area. Muscle strains are commonly caused by over exercising, not warming up properly before exercise and sudden or awkward movements. Treatment for muscle strain is with rest, painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), and the application of ice and heat packs.

Sciatica

Sciatica is a condition where the sciatic nerve (the nerve that runs from your lower back to your feet) is compressed, causing pain and irritation. Common causes include a herniated (slipped) disc, spinal stenosis, and spondylolisthesis. Symptoms of sciatica include a stabbing or shooting pain, tingling, numbness and weakness in your bottom, the backs of your legs, or your feet or toes.

Initial treatment for sciatica involves exercises (your doctor or physiotherapist can advise you on suitable exercises), painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), and the application of heat packs. It may also help to put a small, firm cushion between your knees when lying on your side, or under your legs when lying on your back. Sciatica symptoms normally improve in around 4 to 6 weeks. If home treatments don’t work, your consultant may refer you for physiotherapy, or prescribe stronger painkillers. In some cases, surgery may be recommended.

Ischial bursitis

Ischial bursitis is inflammation of the bursae, the fluid-filled sacs that cushion the ischial tuberosity (sit bone). Common symptoms of ischial bursitis include pain when sitting that may radiate down your thigh, and swelling and redness around the affected area. It is treated with rest, gentle stretching exercises (your doctor or physiotherapist can advise you on suitable exercises), painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), and the application of ice packs to reduce swelling.

Lumbar spinal stenosis

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of the back. This puts pressure on the spinal cord and can cause pain. Symptoms include difficulty walking long distances, pain and numbness in the lower back and buttocks, tingling, numbness and weakness in the legs, and sciatica. Treatment for spinal stenosis includes medication, physiotherapy, and the use of medical devices, such as a back brace. In severe cases, surgery may be necessary.

Herniated (slipped) disc

The bones of the spine are cushioned by small jelly-filled pads called discs. These discs can herniate (bulge out), putting pressure on the nearby nerves and causing pain, numbness, and weakness. If your herniated disc is in the lower (lumbar) spine, this pain can radiate to your buttocks. Other symptoms of a herniated disc include sciatica, weakness, numbness and tingling in the legs, and in severe cases, loss of bladder and bowel control (this is a medical emergency and needs immediate treatment).

Treatment for a herniated disc includes rest, non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy and steroid injections. If these treatments are not effective, surgery may be required.

Piriformis syndrome (Deep gluteal syndrome)

The piriformis muscle is a muscle that runs from your lower back to the top of your thigh. In piriformis syndrome, this muscle spasms and causes buttock pain. The inflamed muscle can also irritate the nearby sciatic nerve, leading to sciatica. Symptoms of piriformis syndrome include sharp, burning or shooting pain in the buttock that may radiate down the thigh, numbness, tenderness when touching the affected area and weakness or tingling in the buttocks and legs. Piriformis syndrome may be caused by injury or trauma to the piriformis muscle, or repetitive activities, such as prolonged sitting, walking, or climbing stairs. The condition is treated with rest, gentle stretching exercises (your doctor or physiotherapist can advise you on suitable exercises), painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), massage, and steroid injections. In very rare cases, surgery may be required.

Haemorrhoids (piles)

Haemorrhoids are enlarged blood vessels around the anus (back passage). They can cause pain around the anus as well as bleeding, itching, and swelling. Mild haemorrhoids can usually be treated with lifestyle changes and medication, but in more severe cases, may need surgery.

Pilonidal cyst (pilonidal sinus)

A pilonidal cyst is an abnormal opening, or hole that forms between the buttocks. It occurs when a hair grows in on itself, and can become infected, causing pain, redness, and swelling. An infected pilonidal cyst may ooze blood or foul-smelling pus. Infected pilonidal cysts are normally treated by draining the cyst, and medication such as painkillers and antibiotics. If your pilonidal cyst is severe, or keeps coming back, your consultant may recommend surgery.

Arthritis

Arthritis is a condition that causes inflammation of the joints, leading to pain, swelling, stiffness, and reduced mobility. Osteoarthritis is caused by wear and tear on the joints and is more common in people over the age of 50. Rheumatoid arthritis is an autoimmune disease that occurs when the body’s immune system mistakenly attacks its own cells. Arthritis in the hip joint can radiate to the buttocks, causing pain and stiffness. Treatment for arthritis includes lifestyle changes, medication, physiotherapy and, in some cases, surgery.

Coccydynia

Coccydynia is pain in the coccyx, or tailbone (the lowest part of the spine). Common causes include injury to the coccyx, activities such as prolonged sitting that put pressure on the coccyx, pregnancy, and childbirth, and being over or underweight. Symptoms of coccydynia include pain in the coccyx that is often worse when sitting, during sex, and when having a bowel movement. Coccydynia is normally treated at home with non-steroidal anti-inflammatory drugs (NSAIDs), avoiding activities that make pain worse like sitting for long periods, or using a doughnut cushion, applying heat or cold packs to the area, physiotherapy, and steroid injections. In very rare cases, surgery may be performed to remove all or part of the coccyx.

Cancer

Very rarely, buttock pain can be a symptom of anal or rectal cancer. Symptoms are often similar to haemorrhoids, and include bleeding, pain, itching, a lump in the anal opening, changes in bowel movements, abnormal discharge, and a loss of bowel control. Most anal and rectal cancers are treatable if caught early, so make an appointment with a specialist if you have any of these symptoms. Treatments include chemotherapy, radiotherapy, and surgery.

Treatment for buttock pain varies depending on the underlying cause. Your consultant will recommend a combination of treatments based on your individual symptoms, diagnosis, general health, and expectations for treatment. They can provide a tailor-made treatment plan suited to your individual needs.

 Treatment for buttock pain may include:

• Lifestyle changes — such as losing weight or stopping smoking
• Rest — rest the affected area until symptoms improve
• Activity modification — avoid activities that make your pain worse
• Heat and cold packs — heat can help relieve pain and ice packs reduce swelling
• Medication — painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids to manage pain and reduce inflammation
• Physiotherapy  — may include exercises to increase strength, flexibility and range of motion, massage, transcutaneous electrical nerve stimulation (TENS), and ultrasound therapy
• Surgery — an operation to find and correct any abnormalities

If your buttock pain is getting worse, or isn’t improving with home treatments, make an appointment to see a doctor. See a doctor immediately if you have:

• Numbness, weakness or tingling in your legs
• Fever (a temperature above 38C)
• Sharp, shooting pain, pain that is getting worse, or not getting better
• Difficulty controlling your bladder or bowels
• A wound that doesn’t heal, or has a strong, unpleasant smell
• Difficulty walking or moving due to pain

At your first consultation, you will be seen by a consultant orthopaedic surgeon, a doctor specialising in conditions affecting the bones, joints, muscles, ligaments and tendons. Your consultant will ask you some questions about your health and symptoms. These may include:

• Your age
• Your medical history
• Your family history
• Your general health
• Any medications you are taking
• Your symptoms
• Any previous injury or surgery
• Whether your symptoms get better or worse after certain activities

Your consultant will examine your buttocks for any outward signs of injury such as swelling, redness, bruising and tenderness.

Will they need tests or scans?

Your consultant may order scans such as an X-ray, CT scan, or MRI to check the bones and soft tissues of your buttocks for abnormalities or signs of disease. They may also order some blood tests to confirm or rule out any underlying medical conditions.

How is a diagnosis made?

Your consultant will make a diagnosis based on a combination of your symptoms, physical examination, and the results of any tests or scans.

Why is this first consultation so important?

Your first consultation is important because it’s where your surgeon will assess your symptoms, provide a diagnosis, and recommend a suitable treatment.

At Circle Health Group, it’s important for us to spend this one-on-one time with you, to get to know you and your expectations for treatment.

Once a diagnosis is made, your consultant will recommend the best treatment options based on your diagnosis, general health, lifestyle, and preferences.

We want you to be as well-informed and comfortable as possible during your time with us, so please feel free to ask any questions, or discuss any concerns you may have with your consultant during your appointment. It’s a good idea to write down any questions you have before your consultation.

We answer some of your most commonly asked questions about buttock pain.

What causes sciatica buttock pain?

Sciatica is caused by pressure on the sciatic nerve, the nerve that runs from your lower back to your feet. It can be caused by several conditions, including a herniated (slipped) disc, spinal stenosis, and spondylolisthesis.

How do you relieve buttock muscle pain?

How you relieve buttock muscle pain depends on what is causing the pain. Some treatments you can try yourself include rest, gentle stretches, avoiding activities that make the pain worse, over-the-counter medications such as paracetamol and ibuprofen, and ice and heat packs. If your buttock pain is getting worse or doesn’t improve with home treatments, make an appointment with a doctor.

How do you relieve buttock pain from sitting?

If you have buttock pain when sitting, it is important to avoid putting pressure on the area. A change of position, such as lying down or taking frequent breaks from sitting to stand and walk around, may help. If you have to sit for long periods, using a type of cushion with a hole in the middle called a doughnut cushion can relieve pressure on the buttocks.

What causes pain in the buttocks?

Buttock pain can have many causes, some of which are discussed above. The only way to be sure what is causing your buttock pain is to get an accurate diagnosis from a doctor. Our specialist consultants can diagnose the cause of your buttock pain by assessing your symptoms, performing a physical examination, and ordering any necessary tests and scans. They can them prescribe an effective treatment plan tailored to your needs.

Can hip problems cause buttock pain?

With some conditions, such as arthritis and spinal stenosis, pain from the hips or spine can radiate to the buttocks. Your consultant will assess your symptoms, perform a physical examination, and order diagnostic scans such as an X-ray, CT, or MRI to determine the cause of your buttock pain.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care, including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about buttock pain treatment, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in January 2024. Next review due January 2027.

• What Is Piriformis Syndrome? Spine health
• What’s Causing This Pain in My Buttocks? Healthline
• Sciatica NHS